She’d always known she’d run into Hollis someday. Fortunately, hospital trips for her were rare. Her whole focus as a midwife was to provide safe, individualized, supportive birthing care at home or in an equally natural setting. On those rare occasions when a patient developed perinatal complications, she arranged their transfer to the nearest hospital if they had no pre-arranged obstetrician, but beyond the phone calls to exchange medical data and her report to the paramedics, her involvement with the hospital establishment ended then. She had hoped this new assignment wouldn’t require her to spend much time at PMC, and she’d hoped even more that she wouldn’t have to deal with Hollis Monroe for a long time to come. So much for hopes, as if she hadn’t learned that a long time ago.

“I’m afraid this won’t work.” Annie grabbed her briefcase. She wanted out of this room and away from the woman who reminded her of one of the worst days of her life. “I’ll find a replacement and have the clinic contact you.”

“That might be a little premature,” Hollis said, suddenly wanting to prove Annie Colfax wrong—despite the fact she’d been of the same mind not ten minutes before. Annie’s abrupt assessment and thinly veiled animosity bothered her more than they should. If the hostility had been purely professional, she might have dismissed it, but she knew it wasn’t and she didn’t know how to redress the past. She’d never had a chance to establish a relationship with Annie. At the first opportunity, Annie had requested another physician, as was her right. Hollis had accepted the decision and stepped aside. She’d understood the decision at the time—Annie was devastated by her unexpected surgery and terrified for the safety of her child. Annie needed to have control of her life, and if firing Hollis and blaming her for the outcome of her precipitous delivery would give her that control, Hollis couldn’t argue. Now so much time had passed she didn’t know this woman, and any explanation she might have offered would have to remain unspoken. “Why don’t we take a few minutes to discuss things. I just found out—”

“I’m sure you’re busy,” Annie said, striding quickly toward the door. “I was just leaving.”

“Ms. Colfax—” Hollis reached out without thinking and Annie shrugged away. Hollis held up her hands and took a step back, giving Annie space. “I’m sorry. Look, I know there were some difficulties between us—”

Annie snorted softly. “That’s a mild way of putting it.”

“Okay.” Hollis sighed. “This is unexpected and…awkward in the extreme, but we’re both professionals—”

“Are we? Tell me, Dr. Monroe, do you see me as your professional equal?”

Hollis had been hoping for détente, but if this was the way Annie wanted to play it, she wasn’t going to sugarcoat anything. “I’m not sure the comparison is fair, but it would be disingenuous of me to say I consider our training equivalent. Our expertise lies in different areas. I will grant that you are probably much better at counseling patients and their families prenatally and in the postpartum care of the mother and baby.” She shrugged. “My specialty is labor and delivery. The other aspects matter, sure, but that’s what I’m trained for.”

“Well, I’m not surprised.” Annie shook her head. “You’re not a whole lot different than many of the OBs I’ve met who somehow think the birthing part of bearing a child can be neatly carved out of the whole experience. Plus, considering your proclivities—”

“Excuse me? My proclivities?”

“You’re a surgeon at heart—and surgeons want to operate. That’s your raison d’être, isn’t it? If you didn’t operate, you’d be just like every other ordinary physician, or in this case, a lot like a midwife.” Annie smiled wryly. “God forbid.”

“So you’re saying I fabricate reasons to operate, that’s where this is going, isn’t it?” Heat flared in Hollis’s chest. She’d expected she and the midwife would have philosophical differences, but she hadn’t expected accusations about her ethics. “You don’t know me well enough to make that kind of assumption.”

Annie stared. “Really? I think I know you just about as well as anyone can, from personal experience. Tell me—what would have happened if you’d waited another ten minutes after Callie—that’s my daughter, in case you’re interested—was delivered? What if you’d continued uterine massage and given the drugs a chance to work? Do you think you might not have needed to take out my uterus?”

“I made a judgment call,” Hollis said. They were going to revisit the past after all. Four years might have passed, but she remembered those last few moments in the OR with absolute clarity. She hadn’t changed her mind. “In my opinion—in my professional, expert opinion—in another ten minutes, as you say, you would have suffered significant organ failure due to protracted blood loss, kidney failure, adult respiratory distress syndrome, and possibly death from hypovolemic shock. My goal was to get you out of that delivery room in the best possible shape so that you could take care of your daughter—”

Annie’s eyes sparked fire. “Don’t use my daughter as an excuse.”

“An excuse?” Hollis resisted the urge to strike back in her own defense, but Annie Colfax had been her patient, and she was angry and still grieving. “I’m sorry you feel that way. I can only tell you, you’re wrong. I did think about her when I made the decision to do the C-section, and I thought about both of you when I made the decision to take out your uterus. And I don’t regret either one.”

“No,” Annie said softly, “of course you don’t. Are you always so certain, Dr. Monroe?”

“When I pick up a scalpel, always.”

Annie’s anger drained away, leaving only an unanticipated melancholy. “That’s the point, isn’t it? You’re always sure it’s time to operate, but my expertise is in knowing when not to operate. In knowing what’s natural and tolerable and ultimately safe before, during, and after delivery. There’s a reason that the United States has one of the highest incidences of cesarean births in the world—because surgeons are making the decisions.”

“It’s pretty clear we’re at an impasse here,” Hollis said.

“For once, we agree.” Annie walked to the door and looked back over her shoulder. She’d thought she’d feel better if she ever had the chance to vent her anger and frustration to the one person who deserved to hear it, but she didn’t. The hint of pain in Hollis’s eyes made for a hollow victory. “Good-bye, Dr. Monroe.”

Chapter Four

Hollis stared at the closed door while she warred with herself about going after Annie. She didn’t like to admit defeat, and even though she had been the one to suggest they were at loggerheads, she wasn’t ready to just walk away without a fight. And that made no sense at all. She didn’t like this whole idea of a combined OB-midwife service—never mind the potential for a medical disaster, just the coordination of appointments, communication between patient, doctor, and midwife, and extra paperwork would be a nightmare. After this morning she had the perfect opportunity to call Dave, report that the concept might be a good one but the execution was impossible, and get on with her work.

The whole mess would disappear, sure, but Annie Colfax would go on believing she was a blade-happy surgeon with a limited vision of the birthing experience, too arrogant to even investigate other possibilities. Not that anything she was likely to do or say would change Annie’s opinion of her. How was she supposed to convince a woman whose mind was made up that she wasn’t who she had appeared to be four years ago, seen through a veil of pain and anger and sorrow?

Annoyed, frustrated, confused by how much Annie’s harsh judgment of her care, Annie’s cold assessment of her, personally, stung, Hollis went back to her desk and pushed files around. She dictated a few follow-up notes and practically cheered when her cell rang and L and D’s number popped up.

“Monroe.”

“She’s ready for you, Hollis,” Patty Richards, the delivery room nurse, said.

“On my way.” Hollis waved to Sybil on the way out. “I’ll be leaving once Mary delivers, as long as everything is okay. If you need me for anything, call me.”

Sybil gave Hollis an appraising look. “That was a pretty short meeting.”

Hollis paused, leaning on the partially open door. Sybil was more than her secretary, she was a trusted confidant who had steered Hollis through the minefield of departmental politics early on in her career. She relied on Sybil’s judgment and thought of her as a friend. “I knew this was going to be touchy. We ran into a few roadblocks.”

“Hmm. She did look a little overheated on the way out.”

“Unfortunately, I think we have a personality conflict.”

“Really?” Sybil frowned. “That’s not like you. I thought I taught you better than that.”

Hollis grinned. “You did, and I’ve managed to keep out of trouble this long.” The brief flicker of humor died when she remembered the pain and anger in Annie Colfax’s eyes. “But this one’s a little different.”

“Anything you want to tell me about?”

“It’s complicated.” Annie wasn’t her patient anymore, but she had been, and what had transpired between them was confidential. She couldn’t really talk to Sybil about it, even though Sybil knew most everything about all of her patients. All the same, what was going on between her and Annie was more than just medical. It was personal in a way that was unusual for her. She cared about all her patients and cared about doing what was right for them. She had complications sometimes, and outcomes less than she desired—if you didn’t, you weren’t operating enough—but she couldn’t remember a time when her judgment or her actions had created such antipathy. She didn’t know how she felt about that, and for the first time the personal and the professional were all tangled up in her head. “Thanks. It’ll sort itself out.”

“I’m sure you’ll handle it,” Sybil said. “You know, Hollis, you’re really, really good at what you do.”

“Thanks. That means a lot.”

“So go get Mary’s baby started in the world.”

Smiling at the prospect of doing what she did best, the one thing that gave her uncomplicated pleasure, Hollis tipped a finger to her forehead in salute. “Yes ma’am. I’ll tell Mary you said hi.”

By the time she got to the delivery room, the nurses had Mary on the table in position. “What’s the status?” Hollis said, holding out her hands for her gown and gloves.

“She’s moving through stage two pretty fast.”

“Pressure?” Mary had had serious hypertension during her last pregnancy, and now was the time when they were likely to see a recurrence.

“Holding nice and steady,” the anesthesiologist said.

Hollis moved to the head of the table and looked down at Mary, who was awake. She’d opted for an epidural to help relieve the pain, but she hadn’t been given any other drugs that might sedate her or the baby. “How are you doing?”

“I’m ready for this to be over.” Mary’s brown hair was black with sweat at the temples and her cheeks flushed from exertion. Her deep green eyes were bright with anticipation.

Hollis’s mood lifted, buoyed by Mary’s excitement. “I’ll just bet you are. Sounds like it won’t be too long. Everything’s going fine.”

Mary searched her face and must have seen the certainty in Hollis’s eyes because she nodded and smiled. “I feel fine. If it weren’t for the God-blessed contractions I’d be perfect. Thank you for this—I can hardly remember the first time.” She caught her breath and her face tightened with a wave of pain.

“No need to thank me,” Hollis said when the contraction passed, noting the time on the big clock on the wall. “You’re the one doing all the work.” She glanced across the table to Mary’s husband, who sat on a high stool holding Mary’s hand. His face was pale above his mask, but his eyes were calm. “You doing okay, Cliff?”

“Just fine,” he said hoarsely. “Mary’s a champ.”

“That she is. So I guess I better get to work or you two won’t think I’m necessary.”

Cliff brushed Mary’s hair, his hand trembling. “Okay, baby, just a little bit longer.”

“Easy for you to say,” Mary grunted.

“Don’t I know it. I love you.”

Hollis eased back down the table and motioned for the circulating nurse to slide over a stool for her to sit between Mary’s legs. When she performed an internal exam, she found the baby’s head ready to emerge. Her pulse jumped. She’d been in this exact position hundreds of times, and every time was still a thrill. In this moment, all that mattered were Mary and this baby. “All systems go. Next contraction, Mary, I want you to push.”